Surgical skill training may be imperative before a surgeon or surgical trainee attempts surgery on live patients. New surgical procedures are constantly being developed that may require both surgeons and surgical trainees to practice new surgical procedures before operating on live patients.
Historically, surgical training has been provided through apprenticeships almost exclusively offered in hospital settings. Residents performed surgery under the supervision of more experienced surgeons. The type of situations presented to the surgeon trainee was largely driven by chance as the nature and timing of situations needing surgery found in patients was not under anyone's control. This model of using a stream of situations as presented by clinical service of human patients may not provide a model for repetition until mastery. As the number of hours that residents are available for surgery has decreased, the range of surgical events presented to surgical residents has also decreased. The failure rate for surgery board certifications exams is now in the range of 26%. For specialized board certifications such as thoracic surgery, the failure rate has been as high as 33%.
For this reason, simulators that provide for realistic surgical environments for surgical training purposes have become increasingly valuable tools. Many known surgical training stimulators exist that use organ models or computer-generated virtual reality systems. These training simulators, however, only provide limited realism and are expensive. For this reason, oftentimes, anaesthetized animals are used for vivo training. However, ethical considerations surrounding the use of the live animals for training is a concern for some. Often times, human cadavers are also used. Like with the use of live animals, concerns still surround the use of cadaver organs as the waste is considered toxic, making clean-up and disposal problematic.
More recently, simulators have been developed that allow for a full operative experience with cardiac surgery and with lung surgery (both open and thoracoscopic) without the use of live animals. Such lifelike simulators can use either animal (e.g., porcine) organs, or human cadaver organs for surgery education and training. The simulators use organs that have been reanimated using hydraulics, reperfusion, and computer orchestration, and are then placed in a human equivalent model.
In one example, the model uses a porcine heart that is prepared with an intraventricular balloon in each ventricle. The balloons are inflated by a computer controlled activator. The computer program is able to simulate the beating heart, various cardiac arrhythmias, hypo- and hypertensive states, cardiac arrest, and even placement of an intra-aortic balloon pump. The model is perfused with a washable blood substitute. When placed in a replica of the pericardial well in a mannequin, the system is capable of duplicating most aspects of cardiac surgery including all aspects of cardiopulmonary bypass, coronary artery bypass grafting both on and off bypass, aortic valve replacement, heart transplantation, and aortic root reconstruction. The computer protocols also make experience with adverse events such as accidental instillation of air into the pump circuit, aortic dissection, and sudden ventricular fibrillation after discontinuation of cardiopulmonary bypass possible.
Descriptions of work on surgical simulators are found in Feins et al. WO 2012/058533; Ramphal et al. U.S. Pat. No. 7,798,815; Cooper et al. U.S. Pat. No. 6,336,812; Hasson U.S. Pat. No. 5,873,732; Szinicz U.S. Pat. No. 5,425,644; and Younker U.S. Pat. No. 5,951,301, all of which are incorporated by reference in their entireties into this application.
Published U.S. Application No. 2015/0024362 to Feins et al. discloses a significant advance in surgical simulation whereby a generally flat tray having a central indentation for receiving an animated animal heart and lung block, is supported on a basket. The entire contents of the published Feins et al. application are incorporated by reference herein. A half torso can be prepped and fixed to the tray over the animal organs. Unfortunately, the relative positioning of the torso and animated animal heart and lung block is fixed. In addition, the set up and disposal of the animal organs may be tedious and cause significant downtime before reusing the simulator.
A need exists to help facilitate and easily repeat such realistic surgical simulations to increase the educational experience and practice achieved through the introduction of the new surgical simulators. In particular, a need exists for the quick and easily set-up, as well as disposal of the organs, so that such simulations can be repeatedly performed without unnecessary downtime in most any environment. In this manner, procedures, tools and techniques can be demonstrated and practiced repeatedly, with minimal downtime between simulations, in most any environment.